Provider Demographics
NPI:1184064610
Name:ORTHOPEDIC SURGICAL PARTNERS, PC
Entity type:Organization
Organization Name:ORTHOPEDIC SURGICAL PARTNERS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCALLISTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-525-4469
Mailing Address - Street 1:1111 CROMWELL AVE STE 403
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3454
Mailing Address - Country:US
Mailing Address - Phone:860-525-4469
Mailing Address - Fax:860-999-9305
Practice Address - Street 1:277 MIDDLE TPKE W
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-3834
Practice Address - Country:US
Practice Address - Phone:860-432-4640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-28
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC01240OtherMEDICARE PTAN
CTC01240OtherMEDICARE PTAN